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BANK OF AMERICA, N.A. (THE “BANK”)
Traditional/Roth IRA Plan
Beneciary Distribution Election Form
1. DECEASED DEPOSITOR INFORMATION
Depositor’s Name Social Security Number
Date of Birth Plan Number
Date of Death Plan Type
Traditional IRA Roth IRA
Bank of America, like all nancial institutions, is required by the USA PATRIOT ACT to obtain, verify, and record information that identies each beneciary
of an IRA account with us. When you are a beneciary of an IRA account with us, we will ask you for your name, address and other information that will allow
us to identify you. The information we gather is for your protection and the country’s against terrorist activity and illegal money laundering schemes.
2. BENEFICIARY INFORMATION
Beneciary Name Social Security Number
Daytime Telephone Number Date of Birth Relationship to Depositor
Physical Street Address, City, State, Zip Source of Income: Employment Investment
Inheritance Retirement/Social Security
Mailing Address (If different) Employer Name (If Employment Selected)
Country of Citizenship
Country of Residency
Occupation (If Employment Selected)
Non U.S. Citizen Required Information
# of Days Present in U.S. This Year
# of Days Present in the U.S. Last Year
# of Days Present in the U.S. During Previous Year
Senior Political Figure and Politically Exposed Persons
Have you or any of your immediate family ever been elected, appointed or assumed any political position in
a National, State, or Provincial government? (Y/N) If yes, describe the position.
3. DISTRIBUTION INSTRUCTIONS
BANK OF AMERICA RECOMMENDS YOU CONTACT YOUR TAX ADVISOR BEFORE MAKING YOUR ELECTION
A beneciary of an IRA Plan should elect how to receive the proceeds of the IRA Plan no later than 09/30 of the year following the year of the IRA
Plan Depositor’s death. Any separate beneciary accounts must be established by 12/31 of the year following the IRA Plan Depositor’s death.
Available options depend on the age of the IRA Plan Depositor, the relationship of the beneciary to the IRA Depositor, and the type of IRA Plan.
SELECT ONLY ONE OF THE PAYMENT OPTIONS BELOW.
Option A.
Always
Available
Lump Sum Distribution
I elect to receive my entire portion of the IRA Plan in a single lump sum payment.
Deposit into my Bank of America
Mail check to the address above.
Checking Savings
State
Life Expectancy
Payments
I elect to receive my entire portion of the IRA Plan by taking payments over the longer of my own life
expectancy or the remaining life expectancy of the deceased IRA Plan Depositor.
Specic Amount
I elect to receive my entire portion of the IRA Plan by taking payments of
Specic Term
I elect to receive my entire portion of the IRA Plan by taking payments over
year
5-Year Payout
I elect to receive my entire portion of the IRA Plan by 12/31 of the year containing the 5
th
anniversary
of the IRA Plan Depositor’s death. (Only available if the deceased IRA Plan Depositor was under the
age of 70½ on the date of death
Option B.
Additional Options
for Spouse Only
Spouse Treat as Own
I am the spouse of the deceased IRA Plan Depositor and I elect to treat the assets of the IRA Plan as
my own IRA.
Spousal Exception
I am the spouse of the deceased IRA Plan Depositor and I elect to delay taking distributions until the
year my spouse would have reached age 70½. Date:
NOTE: Under both options, additional amounts may be withdrawn at any time.
4. RMD PAYMENT INSTRUCTIONS
You are responsible for taking your annual Required Minimum Distribution (RMD) from the IRA Plan. The Bank will not distribute your RMD unless you give the
Bank timely written distribution instructions.
The Specic Start Date is limited to any date between January 7
th
and December 28
th
. If date selected is a non-business
day, the distribution will be processed on the rst business day following the date.
Select One:
Monthly Quarterly Semi-Annually Annually Specic Start Date
Select One:
Mail check to the address above. Deposit into my Bank of America Checking Savings
Form 00-59-1289NSBW–Version 051712